Nonopioid Analgesics

Nonopioid analgesics reduce pain without directly activating opioid receptors. The group is not pharmacologically uniform, so the medication name alone does not tell you whether it is appropriate. Acetaminophen is primarily an analgesic and antipyretic. It is useful when inflammation is not the main treatment target, but excessive total exposure can cause serious liver injury. The total must include combination products and over-the-counter preparations, not only the tablet that appears on the medication administration record. Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen, reduce pain, fever, and inflammation. Their benefit comes with a different risk pattern: gastric or intestinal injury, bleeding, impaired renal perfusion, fluid retention, increased blood pressure, and cardiovascular harm. A patient may therefore need an NSAID for inflammatory pain but still be an unsafe candidate for that class. The gastrointestinal question is often the deciding question. A patient with an ulcer history, anticoagulant therapy, or unexplained anaemia is not simply “a person with pain”; that history changes the risk-benefit balance before the first dose.